Organization
CAREFIRST OF NM INC
Active
Other names
Willow Wood
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KALTENBACH (PRESIDENT)
(505) 856-8553
Entity
Organization
Contact information
Practice address
1008 CHIRICAHUA CT SE, ALBUQUERQUE, NM 87123-5918
(505) 856-8553
(505) 213-0857
Mailing address
PO BOX 21114, ALBUQUERQUE, NM 87154-1114
(505) 856-8553
(505) 213-0857
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2292
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15682790
—
NM
Enumeration date
03/25/2016
Last updated
03/25/2016
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